- Ανακοίνωση στο συνέδριο της ASTRO 2007 (American Society Therapeutic Radiology Oncology) στο Los Angeles, USA
Combined Proton and Photon Conformal Radiotherapy for Intracranial Atypical and Malignant Meningioma
CHRISTOS BOSKOS*₪, LOIC FEUVRET*†, GEORGES NOEL∞, JEAN-LOUIS HABRAND*, PASCAL POMMIER٭, CLAIRE ALAPETITE*, HAMID MAMMAR‡, REGIS FERRAND*, GILBERT BOISSERIE†, JEAN-JACQUES MAZERON†
* Institut Curie - Centre de Protonthérapie d’Orsay. Campus Universitaire, Batiment 101, 91898 Orsay Cedex, France
₪ 251 General Hospital of Airforce, 4, Kanelopoulou , Athens, Hellas
† Hôpital Pitié Salpêtrière, 47-83, boulevard de l’Hopital, 75651 Paris Cedex 13, France
∞ Centre Paul Strauss, 3, rue de la Porte de L’Hopital, 67085 Strasbourg Cedex, France
٭ Centre Léon Bérard, 28, rue Laennec, 69373 Lyon Cedex 08, France
‡ Centre Antoine Lacassagne , 33, avenue Valombrose, 06189 Nice Cedex 2, France
PURPOSE: To evaluate retrospectively the efficacy of conformal fractionated radiotherapy combining proton and photon beams after primary surgery for the treatment of atypical(AM) and malignant(MM) meningiomas.
PATIENTS AND METHODS: Between September 1999 and October 2006, 24 patients (12 males, 12 females) with histopathologically proven meningioma (atypical 19, malignant 5) received postoperative combined radiotherapy with a 201 MeV proton beam at the Centre Protontherapie d’Orsay (CPO) and a high energy photon beam . Six patients underwent gross total resection and eighteen a subtotal resection. Median gross tumor volume and clinical target volume were 44.7 cc and 153.3 cc, respectively. Mean total irradiation dose was 65.01 CGE (cobalt gray equivalent) with mean proton total dose 34.05 CGE and mean photon total dose 30.96 CGE.
RESULTS: The median follow up interval was 32.2 months [1-72]. The overall mean local relapse-free interval was 27.2 [10-50]months, 28.3 [10-50] for AM and 23 [13-33] for MM. Ten tumors recurred locally. One-, 2-, 3-, 4-, 5-, 8- year local control rates for the entire group of patients were: 82.9 ±7.8, 82.9±7.8, 61.3±11, 61.3±11, 46.7±12.3, 46.7±12.3, respectively. One-, 2-, 3-,4-,5-, 8- years overall survival rates were: 100%, 95.5±4.4, 80.4±8.8, 65.3±10.6, 53.2±11.6, 42.6±13, respectively. Survival was significantly associated with total dose. There was no acute morbidity of radiotherapy. One patient developed radiation necrosis 16 months after treatment.
CONCLUSIONS: Postoperative combination of conformal radiotherapy with protons and photons for atypical and malignant meningiomas is a well-tolerated treatment producing long-term tumor stabilization.
Περισσότερες λεπτομέρειες μπορείτε να δείτε στην ηλεκτρονική διεύθυνση: http://astro2007.abstractsnet.com/acover.wcs?entryid=500207
- Ανακοίνωση στο συνέδριο της ASTRO 2009 (American Society Therapeutic Radiology Oncology) στο Chicago, USA.
3-D VOLUMETRIC EVALUATION OF RESPONSE IN 117 METASTATIC BRAIN MELANOMAS TREATED WITH BEAM-SHAPE RADIOSURGERY
C. BOSKOS(1,2), A. GORGULHO(1), Ch. VALERY(3), M.A. DE PAIVA(1), M.T. SELCH(1), N. AGAZARYAN(1), G. BOISSERIE (3), Α. DE SALLES(1).
(1) UCLA, Radiosurgery Department, Los Angeles, California, USA
(2) 251 General Hospital of Airforce, Oncology Department, Athens, GREECE.
(3) Hôpital Pitié-Salpêtrière, Radiosurgery Department, Paris, FRANCE
Introduction: We report retrospectively the response of melanoma brain metastases treated with stereotactic radiosurgery (SRS) in UCLA Radiosurgery Department, evaluating the volumetric changes from the day of treatment.
Patients and methods: We evaluate 117 melanoma brain metastases in 39 patients (28 male, 11 female) treated with SRS. We use for SRS treatment a Novalis® 6 MV, with micro multileaf collimator M3® and software iPlan3®. The volumetric study of these patients was based on MRI images before and after SRS. Patients are selected with minimum follow up of 5 months and at least 2 MRI in this interval. Median follow up was 9.16 months (5.1 - 41.7). We induce the term of “speed of shrinkage” and “speed of growth” as the ratio between percentage of shrinkage or growth respectively and the interval. “Volumetric response” defined as decrease of the volume (shrinkage).
Median prescribed peripheral dose was 18Gy (range: 10-25) to the 90% prescription isodose line. Median age was 52 years (range: 27-77), median grade of Karnofsky index was 90 (range: 60-100) and mean volume 2.25 cm³ (range:0.03-32.23). Overestimated increased contrast enhanced volume was found in 6 hemorrhagic metastases which was excluded from the study
Results: Volumetric response reported in 95.3% of metastases with a mean delay to response 3.13 months (median 3.25). A subgroup of initially responding metastases (13.9%) finally relapsed with a mean delay of 7 months (median 6.69).
According to Kaplan-Meier analyses, actuarial LC for 6-month, 1-year and 2-years was 91.6%, 82%, 77.6% respectively.
For “LC group” median percentage of shrinkage was 80% (mean: 71%) and median speed of shrinkage 8%/month (mean: 9%). For “Relapsed group” median percentage of growth was 205% (mean: 191%) and median speed of growth 28.7%/month (mean: 98).
Small initial volume and increased speed of shrinkage found to be favorable predictor factors for complete response.
Conclusions: According to the accurate volumetric evaluation of melanoma brain metastases, SRS found to be an efficient therapeutic approach, in terms of decreasing volume, with a median delay for response 3.13 months. Speed of shrinkage and initial tumor volume are favorable predicting factors for complete response.
Περισσότερες λεπτομέρειες στην ηλεκτρονική διεύθυνση: http://astro2009.abstractsnet.com/aposter.wcs?entryid=060119
- Ανακοίνωση στο 9o παγκόσμιο συνέδριο Στερεοτακτικής Ακτινοχειρουργικής (ISRS), Σεούλ, Ν. Κορέα, 2009
Σύντομα θα προστεθεί η ανακοίνωση
Περισσότερες λεπτομέρειες στην ηλεκτρονική διεύθυνση: http://www.isrs2009.org/site/program.php?all=1
- Ανακοίνωση στο Πανευρωπαϊκό συνέδριο της ESSFN 2010 (European Society for Stereotactic and Functional Neurosurgery) στην Αθηνα.
CEREBRAL METASTASES OF BREAST CANCER TREATED BY LINAC-RADIOSURGERY
Περισσότερες λεπτομέρειες στην ηλεκτρονική διεύθυνση: http://www.essfn2010.org/?pid=7
- Ανακοινωση στο 10o παγκόσμιο συνέδριο Στερεοτακτικής Ακτινοχειρουργικής (ISRS), Παρίσι, Γαλλία, 2011
P2049 BRAIN METASTASES FROM BREAST CANCER TREATED WITH LINAC- RADIOSURGERY: PREDICTING FACTORS FOR DISTANT RELAPSE
Christos Boskos (Paris, France) 
Περισσότερες λεπτομέρειες στην ηλεκτρονική διεύθυνση: http://www.colloquium.eu/scient/11ISRS/programme/info.php?id=70
